Laparoscopic three-port distal pancreatectomy.

Aims: Laparoscopic distal pancreatectomy is becoming a more commonly used procedure, which may involve the use of four to seven ports, depending on the technique. Initial data on feasibility, safety and outcome with the three-port laparoscopic distal pancreatectomy are presented.

Methods: The patient is placed in a partial thoracoabdominal position exposing the left flank in a reverse Trendelenberg position. A 10-mm Hassan trocar is inserted through a subcostal anterior axillary incision. A 5-mm midclavicular and 10-mm posterior axillary line trocar are placed. The specimen is retrieved from the anterior axillary line port.

Results: Ten women and seven men, aged 26-88 years (mean 61 years), were evaluated. Their body mass indexes ranged from 18-37 (mean 27). Pancreatic lesion size ranged from 1.0-5.5 cm (mean 3.0 cm). Operative time was 116-296 min (mean 170 min). Blood loss was 10-300 ml (mean 142 ml). No operation required conversion or additional trocar placement. Post-operative stay was 2-7 days (mean 4 days). No patient developed a pancreatic fistula.

Conclusion: Operative time, blood loss and post-operative stay of this three-port technique compare favourably with published data.